Health reform may lead to doctor shortage, Hopkins and UMMS execs say

It's not like these outcomes weren't foreseeable - not only will there be fewer doctors who choose to be primary care physicians, more will drop out. (More here: http://www.realjock.com/gayforums/2512364). Canada's system of rationing depends on doctors earning less - and with costs mounting, that's an increasingly larger burden doctors are going to be forced to bear - primary care and specialists. In talking with my friends who are doctors, there are a number who are considering to retire and even a few at the periphery who are considering opting out of the system altogether (which, is drastic as it means you can't accept any public money). More on that here - http://news.nationalpost.com/2012/07/09/ontario-doctors-launch-constitutional-challenge-in-bid-to-reverse-fee-cuts/

The outcomes are predictable and they were predicted. But leave it to extremists to try to blame Republicans while supporting an idiotic law crafted by lobbyists and liberal ideologues.

The federal Affordable Care Act does not do enough to increase the number of doctors to care for the influx of patients the law will create, executives of two of the largest hospital systems in the Baltimore area said on Monday.

Federal health reform will qualify hundreds of thousands more Maryland residents for health insurance and place greater emphasis on primary and preventive care. But the law does not support a correlating growth in the number of doctors to care for those patients, the leaders of Johns Hopkins Hospital and Health System and University of Maryland Medical System said at a panel discussion about the law hosted by the Greater Baltimore Committee .

“There hasn’t been much thought given that we’ll have to expand the ranks,” said Ronald R. Peterson, president of Johns Hopkins Hospital and Health System.

Meanwhile, medical schools are not churning out a greater number of doctors and only a handful of those graduates pursue primary care, said Robert Chrencik, CEO of University of Maryland Medical System. Most graduating medical students gravitate toward futures as surgeons or specialists, which they see as more viable long-term careers with more stable incomes.

“Just a small portion are primary care,” Chrencik said.

The GBC forum was held nearly two weeks after the U.S. Supreme Court voted to uphold President Barack Obama's health care reform bill.The challenge Maryland faces is to not only increase the number of primary care physicians in its ranks, but to entice them to set up shop in the communities that need them most.

The greatest growth in demand for primary care physicians will be among poorer communities, where many residents are uninsured or under insured. But already, some private physicians have stopped accepting Medicare and Medicaid patients because the payment rates for the federal and state programs do not cover the cost of care.

The new healthcare will be a Huge improvement. It will increase preventative care and make doctors' jobs a lot easier, while improving the lives of people who for whatever reason happen to lower on the income scale

HottJoe saidThe new healthcare will be a Huge improvement. It will increase preventative care and make doctors' jobs a lot easier, while improving the lives of people who for whatever reason happen to lower on the income scale

Riddler !! come on now man !!! Surely you don't believe and take the word of all these people who have a vested interest in 'Obamacare' failing ? The leaders of their movement have that behind their cause, but the masses are just duped follower follower types, basicly sheeple who only believe what their leader FOX NEWS tells them to.

Granted, 'ObamaCare' is far from perfect and came about as a result of an imperfect system in our government due mostly to lobbying out what would have made the program better. But this 'ObamaCare' at its worst is a far better place to start for continual improvement than where we were under Bush and going back to Reagan.

Remember that before it was Obama's Idea, we had Romney doing very similar in his state and even the far right DeMint in South Carolina calling for universal insurance. When aspects of this program were republican ideas, all was well, but when Obama's name was attached, those same ideas became a way to bring about Obama's "Waterloo".

Incentives can encourage new doctors to become primary care physicians, and encourage those new doctors to locate in underserved areas. The (gasp!) government has successfully used these incentives in the past. Problem solved.

HottJoe saidThe new healthcare will be a Huge improvement. It will increase preventative care and make doctors' jobs a lot easier, while improving the lives of people who for whatever reason happen to [ be ] lower on the income scale

Though I gotta ask, how do you think that preventative care is going to be implemented in ACA?

People who are currently uninsured who cannot afford preventive care wind up in hospital emergency rooms after their condition becomes life threatening, with the cost of treatment tens or hundreds of times more expensive. It's like not fixing a small leak in the roof, and waiting until the roof collapses to repair the problem.

HottJoe saidThe new healthcare will be a Huge improvement. It will increase preventative care and make doctors' jobs a lot easier, while improving the lives of people who for whatever reason happen to [ be ] lower on the income scale

Though I gotta ask, how do you think that preventative care is going to be implemented in ACA?

People who are currently uninsured who cannot afford preventive care wind up in hospital emergency rooms after their condition becomes life threatening, with the cost of treatment tens or hundreds of times more expensive. It's like not fixing a small leak in the roof, and waiting until the roof collapses to repair the problem.

realifedad saidRiddler !! come on now man !!! Surely you don't believe and take the word of all these people who have a vested interest in 'Obamacare' failing ? The leaders of their movement have that behind their cause, but the masses are just duped follower follower types, basicly sheeple who only believe what their leader FOX NEWS tells them to.

Granted, 'ObamaCare' is far from perfect and came about as a result of an imperfect system in our government due mostly to lobbying out what would have made the program better. But this 'ObamaCare' at its worst is a far better place to start for continual improvement than where we were under Bush and going back to Reagan.

Remember that before it was Obama's Idea, we had Romney doing very similar in his state and even the far right DeMint in South Carolina calling for universal insurance. When aspects of this program were republican ideas, all was well, but when Obama's name was attached, those same ideas became a way to bring about Obama's "Waterloo".

Not quite the same thing. As for vested interests - you do realize of course you're listening to people who also have vested interests? The importance is wading through the evidence... What is however quite clear is that countries like Canada suffer from a shortage of primary care physicians... you should be asking why given you're interested in seeing the poor and vulnerable covered by healthcare insurance...

Soo here's the other apocalypse swing... So now we've determined that too many people will be able to get healthcare (oh the horror!!) instead of the typical shtick that everyone will be dropped from healthcare by their jobs.

Is there a shortage of primary care docs? Yes. Obamacare doesn't go far enough in forming incentives for primary care physicians but it does some (which is what leads to some changes and why some of the more expensive and cosmetic fields [derm and plastics] aren't the happiest).

There is growing emphasis on the role of RNs, NPs, PAs, and even MAs and social workers in primary care. By doing this, many simple problems are triaged from doctors and other problems are followed up via phone and lead to lower "bounce back" rates which help reduce workloads on doctors. It doesn't alleviate all of the increased burden, but it's a great start and is having positive outcomes for patients as well. Idea: if you tackle simple medical and social issues, you provide better care. Better care = less doctors visits and hospitalizations.

There does need to be greater incentives for pcps, however. The debt repayment programs don't go far enough in acting as appropriate incentive... Not when a dermatologist can still charge 20 or 30 bucks for every mole or AK they freeze off in 2 seconds.

riddler78 saidIt's not like these outcomes weren't foreseeable - not only will there be fewer doctors who choose to be primary care physicians, more will drop out. ...

Consistent with my discussion with the medical professionals in my area. One physician made some good points regarding the 83% of physicians who are considering quitting. He said most probably won't quit unless they are close to retirement or have other income sources. He said the morale will be bad, not just because they would have difficulty being compensated consistent with their costs, but also because they would not be able to treat patients as they had become accustomed to.

The other factor relates to the quality of medical professionals in the future. No reflection on the physicians content to be employees of some organization and get a modest pay, but medicine has attracted some of the best and brightest in the past because the rewards for all the years of training and sacrifice used to be a very comfortable lifestyle and financial security. If those rewards are taken away, along with being forced into treatments per government restrictions, there will be less incentive for the very best to enter the field.

The net impact would be similar to what socialism provides for other aspects of society, specifically good service for the very wealthy, and mediocre, but equal service for the rest. The class envy and class warfare which the far left loves would not be satisfied, because the very wealthy will still get better service.

I think as the messages get out, which the left will call fear-mongering, the ugly realities of Obamacare will hit home, and the real surgery, the removal of the left-wing malignancy from the Government, will be successful.

Christian73 saidI "married" into an entire family of doctors and not one of them is considering quitting. Must be that pesky 17%.

Large hospital systems in Oregon and Virginia must also be part of that 17% that was part of the 4% of actual respondents of a valid poll by a well known and non politically associated organization whose sample adequately represents the physician population as it exists in practices.

I don't know, Riddler. You once boasted on a topic about having doctors in your family and when I asked why they weren't down in the US making millions and millions you said they were practicing in Canada for 'personal reasons'.

So then, where are all these doctors abandoning the US ship going to go?

meninlove said I don't know, Riddler. You once boasted on a topic about having doctors in your family and when I asked why they weren't down in the US making millions and millions you said they were practicing in Canada for 'personal reasons'.

So then, where are all these doctors abandoning the US ship going to go?

From what I've understood - a number will just retire. This is what for instance, a few of the specialists I know in Ontario are considering doing. They're already close to the age of retirement, they don't need the hassle. They'll "go galt" as it were. As for others? It's a good question to ask of them - but my guess is that there will be opportunities where some of the best continue have opportunities elsewhere but perhaps not in primary care.

meninlove said lol, I know several US docs that are now up here. Less hassle, single payer, far less paperwork, and hey they make upwards of 400k a year. Specialists make up to 700k annually.

Go galt is so hilarious and ridiculous a conc...oh wait. I forgot, you're a Rand-er. Eventually you'll get over it. Life has a way of making Rand's teaching the foolishness that they are.

Yep which only goes to show how ignorant you are for instance to the changes that are happening in Ontario for instance. . I'm not precisely sure what you'd like me to get over. The fact is that the ideas you continue to trumpet are failing and really have failed for the simple fact they've been unsustainable - that's not "randian", it's just math.

You just keep on doing what you think you know how to do best. There are years ahead for you to be able to eat the words you post now. Do remember though, that crow is best eaten when young and the feathers still soft.

Thank you I will. But I will point out one additional point - you seem to think that the US system will get better based on the parameters you've described - "Less hassle, single payer, far less paperwork, and hey they make upwards of 400k a year"

You just keep on doing what you think you know how to do best. There are years ahead for you to be able to eat the words you post now. Do remember though, that crow is best eaten when young and the feathers still soft.

Which is unfortunate for you having to eat crow so often at an age as addled as yours

I think volunteering in medical care might open your eyes, but I think you too squeamish for the graphic nature of palliative and elder care. You meet a great many doctors that way and find out what they're about, not the greedy ones that make up a small percentage of the whole.

As well, you really haven't a clue as what I know or think about our system. I play my cards close to my chest on here simply because it's a wasteful expenditure of intellect and time.